Cuff for use with medical tubing and method and apparatus for making the same

- Covidien LP

A method of manufacturing more than one inflatable cuff per blow molding operation is provided. The method includes using two or more molds arranged in series and/or in parallel to simultaneously form two or more cuffs. The two or more cuffs may then be used in the manufacture of two or more respective endotracheal tubes. Apparatuses and systems for simultaneously forming the two or more cuffs are also provided.

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Description
BACKGROUND

The present disclosure relates to medical devices, and more particularly, to tracheal tubes and other tubes designed to form a seal against a surrounding passage.

This section is intended to introduce the reader to various aspects of art that may be related to various aspects of the present invention, which are described and/or claimed below. This discussion is believed to be helpful in providing the reader with background information to facilitate a better understanding of the various aspects of the present invention. Accordingly, it should be understood that these statements are to be read in this light, and not as admissions of prior art.

Within the course of medical treatment, a tube or other medical device may sometimes be used to control the flow of air, food, fluids, or other substances into a patient. For example, medical devices (such as various types of tubes and catheters) may be used to control the flow of one or more substances into or out of a patient. In many instances it is desirable to provide a seal between the outside of the tube or device and the interior of the passage in which the tube or device is inserted. In this way, substances can only flow through the passage via the tube or other medical device, allowing a medical practitioner to maintain control over the type and amount of substances flowing into and out of the patient.

For example, tracheal tubes may be used to control the flow of air or other gases through a patient's trachea. Such tracheal tubes may include endotracheal tubes or tracheostomy tubes. To create a seal between such tubes and the tracheal wall, an inflatable cuff is typically employed. When inflated, the cuff may prevent air from flowing into or out of the patient's lungs except via the tube. In this manner, major air leaks during positive pressure ventilation, i.e., when air is being pushed into the lungs, and gas leaks during anesthesia procedures may be prevented.

The cuffs employed on devices such as endotracheal tubes or tracheostomy tubes may be manufactured from a variety of polymeric compositions, such as polyurethane (PU) or polyvinyl chloride (PVC). It may be desirable to manufacture such cuffs while wasting as little of the polymeric composition as possible and/or to improve the efficiency of the manufacturing process.

BRIEF DESCRIPTION OF THE DRAWINGS

Advantages of the invention may become apparent upon reading the following detailed description and upon reference to the drawings in which:

FIG. 1 illustrates a tracheal tube, in accordance with aspects of the present disclosure;

FIG. 2 illustrates a tracheal tube deployed within a trachea, in accordance with aspects of the present disclosure;

FIG. 3 illustrates a blow molding machine, in accordance with aspects of the present disclosure;

FIG. 4 is a flow chart depicting acts for manufacturing inflatable cuffs, in accordance with aspects of the present disclosure;

FIG. 5 depicts an embodiment of molds arranged in series in accordance with aspects of the present disclosure;

FIG. 6 depicts a further embodiment of molds arranged in series in accordance with aspects of the present disclosure;

FIG. 7 depicts an additional embodiment of molds arranged in series in accordance with aspects of the present disclosure;

FIG. 8 depicts a further embodiment of molds arranged in series with a gap spacing the molds apart, in accordance with aspects of the present disclosure;

FIG. 9 depicts an additional embodiment of molds arranged in series with an additional clamp disposed between the molds, in accordance with aspects of the present disclosure;

FIG. 10 depicts an embodiment of cuff molds arranged in parallel in accordance with aspects of the present disclosure; and

FIG. 11 depicts an embodiment of cuff molds arranged in series and in parallel in accordance with aspects of the present disclosure.

DETAILED DESCRIPTION OF SPECIFIC EMBODIMENTS

One or more specific embodiments of the present invention will be described below. In an effort to provide a concise description of these embodiments, not all features of an actual implementation are described in the specification. It should be appreciated that in the development of any such actual implementation, as in any engineering or design project, numerous implementation-specific decisions must be made to achieve the developers' specific goals, such as compliance with system-related and business-related constraints, which may vary from one implementation to another. Moreover, it should be appreciated that such a development effort might be complex and time consuming, but would nevertheless be a routine undertaking of design, fabrication, and manufacture for those of ordinary skill having the benefit of this disclosure.

A variety of medical devices are designed to be inserted within cavities or passages of the human body. Examples of such medical devices include catheters, stents, feeding tubes, intravenous tubes, breathing tubes, and so forth. In many instances it is desirable that the device be provided with an inflatable cuff that can be used to form a seal between the medical device and the surrounding passage or cavity. In accordance with aspects of the present disclosure, such a cuff may be manufactured using more than one mold (either in series or in parallel) and/or using molds having more than one cuff-shaped cavity such that more than one cuff may be formed in each molding operation. In addition to increasing the number of cuffs formed in each operation, such an approach may also increase the number of cuffs that can be produced using a given length of tubing material. In this manner, the number of cuffs produced per molding operation may be increased and/or the amount of tubing material wasted (i.e., not being used to form a cuff) may be decreased.

With the foregoing in mind, an example of a medical device that may include a cuff is an endotracheal tube 10, as depicted in FIG. 1. The endotracheal tube 10 includes an inflatable cuff 12 that may be inflated at low pressure (approximately 25 cm H2O or less) to form a seal against the trachea wall 14 (see FIG. 2). Typically the inflatable cuff 12 is inflated and deflated via a tube 16 in communication with the inflatable cuff 12.

For simplicity, the present example describes the use of an inflatable cuff 12 in the context of an endotracheal tube. However, an inflatable cuff 12 may be used with other medical devices, such as those listed above, or with other devices in which it is desirable to form a seal between the device and a surrounding passage or pathway. Therefore, it should be understood that the present examples and descriptions are merely exemplary and are not intended to limit the scope of the present disclosure.

Returning now to FIG. 1, in accordance with the one embodiment, the wall of the inflatable cuff 12 is about 0.00086 inches (0.022 mm) thick or less. In addition, the walls of the inflatable cuff 12 are made of a material having suitable mechanical properties (such as puncture resistance, tear resistance, pin hole resistance, tensile strength), chemical properties (such as forming a suitable bond to the main tube body 18), and biocompatibility.

In one embodiment, the walls of the inflatable cuff 12 are made of a polyurethane or polyurethane-based composition having suitable mechanical and chemical properties. An example of one suitable polyurethane is Dow Pellethane® 2363-90AE. In other embodiments, the walls of the inflatable cuff 12 are made of other suitable compositions, such as compositions having suitable mechanical properties at the desired wall thickness of the cuff 12. Examples of suitable polymeric compositions may include polymethylmethacrylate (PMMA), polyacrylonitrile (PAN), polyamide (such as nylon) (PA), polycarbonate (PC), polyesters (such as polyethylene terephthalate (PET)), polyolefins (such as polyethylenes (PE) and polypropylenes (PP)), polystyrene (PS) or vinyls (such as polyvinyl chloride (PVC) and polyvinylacetate). Other polymers and/or polymer admixtures having suitable mechanical, chemical, and biocompatibility properties may also be used to form the cuff 12.

In the embodiment depicted in FIG. 1, the cuff 12 is shaped as being generally tapered, being wider at one end when inflated. As will be appreciated by those of ordinary skill in the art, the degree of taper, curvature and/or linearity at different parts of the cuff 12 may vary. As depicted in the embodiment of FIG. 1, the cuff 12 may be secured at the proximate end 20 and distal end 22 to the main tube body 18, such as by collar regions 24 adhered, fused, or otherwise attached to the main tube body 18. However, the cuff body 26 between the proximate end 20 and the distal end 22 forms an expanded structure between these ends when partially or completely inflated. As depicted in FIG. 2, when inflated in the trachea, portions of the inflated cuff 12 may be partially flattened against the trachea wall to form a seal against the tracheal wall 14.

While the cuff 12 in FIG. 1 is depicted as tapered when inflated, in various exemplary embodiments the inflatable cuff 12 may be shaped differently when inflated. For example, the cuff may be tapered differently or opposite to what is depicted in FIG. 1, or may be generally symmetrical, without a substantial taper from one end to the other. Likewise, other cuff shapes having straight walls, curved walls, or combinations of straight and curved walls are possible and are within the scope of the present disclosure. The collar regions 24 adhering or otherwise attaching the various cuffs to the respective main tube bodies 18 are typically the same or about the same diameter as the main tube body 18.

The inflatable cuffs 12 discussed herein may be formed by various techniques. In one implementation, the inflatable cuff 12 is formed by blow-molding. For example, in one such implementation a preformed tubular polyurethane extrusion is blow-molded to form the cuff 12. The tubular extrusion has a suitable internal diameter and wall thickness such that, when the extrusion is blown, the resulting cuff 12 has a sufficient internal diameter to fit onto an endotracheal tube 10 and has the desired wall thickness.

For example, a tube, such as a preformed extruded polyurethane tube, may be loaded into a mold assembly 40 of a blow molding machine 38, as depicted in FIG. 3. A suitable blow molding machine 38, such as an angioplasty balloon blowing machine, may allow process parameters such as the stretch of the preformed tube, blow pressure, and temperature to be controlled. In one embodiment, the blow molding machine 38 may be a model 2210 computerized balloon forming machine, available from Interface Associates, which is configured to run at 1-2 bars of gas pressure.

In an embodiment, the mold assembly 40 may include two or more molds 42 (FIGS. 5-11) housed (serially and/or parallel to one another) within common or separate heating/cooling jackets 44. In one embodiment, the molds 42 may be manufactured from beryllium copper and may be split horizontally to allow opening and closing of the mold 42 when not in the respective jacket 44. The heating/cooling jackets 44 may house one or more molds 42 as well as components for heating and/or cooling the molds 42. For example, the heating/cooling jackets 44 may include passages, conduits, or open areas through which coolant (such as cooled water) may flow to actively cool the molds 42. In addition, the heating/cooling jackets 44 may include one or more heating cartridges or other heating elements (such as resistive heating elements which heat when a current is passed through the element) which may be used to actively heat the molds 42. For example, in one embodiment, the heating/cooling jacket 44 includes a series of ten electrical heating elements used to heat the molds 42. In this manner, the heating/cooling jackets 44 may actively regulate the temperature of the molds 42 contained within.

The mold assembly 40 may be bracketed on either side by clamp structures 50 that secure respective ends of the tube 46 when placed within the mold assembly 40. One or both of the clamp structures 50 may include nozzles which are secured within the end of the tube 46 when clamped and which allow a gas (such as nitrogen) to be injected at pressure into the secured tube 46. In one embodiment, the clamp structures 50 may move outward with respect to the mold assembly 40 such that a secured tube 46 may be placed under tension.

In one implementation, a length of tube 46 which is inserted into the mold assembly 40 and secured by the clamps 50 may be approximately 12 inches (30.48 cm) in length prior to being placed under tension. In general, the tube 46 may be between about 10 to about 12 inches (i.e., approximately 25 cm to 30 cm) in length when inserted into the mold assembly 40 and secured by the clamp structures 50 prior to application of tension. In one embodiment, the end-portions of the extruded tube 46 that project out from the mold 42 are constrained to the shape and thickness of the original extruded tube by non-heat transferable plastic holders at the ends of the mold 42.

As depicted, the blow molding machine 38 may include a control station 54, which may include a user interface and/or controls, a monitor, and so forth. The control station 54 may display current status information for a blow molding operation and/or may display a user interface with which a user can interact to select, initiate, and/or control one or more programs or operations to be performed by the blow molding machine 38. Such programs or operations may coordinate operation of the clamps 50 in applying tension to a tube 46, may control heating and cooling of the jackets 44 such that a particular temperature profile is achieved with respect to the mold 42 over time, and may control injection of pressurized gas into the tube 46 as part of a blow molding process.

In one embodiment, the control station 54 may include a touch sensitive screen by which the user interacts with the interface, though in other embodiments, a keyboard and mouse or other similar interface may contain buttons or keys by which the user interacts with the displayed user interface. In one embodiment, the control station 54 may be a programmed computer configured to display a user interface and status information, to receive user commands, and to control operation of other components of the blow molding machine 38. In other embodiments, the control station 54 may be any suitable processor based system or components configured to perform some or all of these functions. Such computers or other processor based systems may include one or more processors as well as memory and storage components suitable for storing and executing routines and/or programs as discussed above for controlling operation of different components of the blow molding machine 38.

With the foregoing in mind, and turning now to FIG. 4, a flowchart is depicted setting forth a method 60 for forming cuffs for a medical device in accordance with one embodiment of the present disclosure. In this method 60, two or more molds 42 (FIG. 3) are loaded and secured (block 62) within one or more respective heating/cooling jackets 44. For example, the molds 42 may be loaded into the respective jacket or jackets 44 and pneumatically locked into place once loaded. In one embodiment, the molds 42 may be loaded in series (i.e., end-to-end) within a common jacket 44 or in separate respective jackets 44. In other embodiments, the molds 42 may be loaded in parallel (i.e., side-by-side) within a common jacket 44 or in separate respective jackets 44. In another embodiment, four or more molds 42 may be employed and may be loaded and secured in a common jacket 44 or in separate respective jackets 44 in both series and parallel configurations, i.e., some of the molds 42 may be situated end-to-end while also being side-by-side with other molds 42.

In the depicted method 60, a blow molding program is loaded (block 64) to a blow molding machine 38, such as via operation of the control station 54. The blow molding program may control a cycle of operation of the blow molding machine 38 during which two or more cuffs will be formed using the loaded molds 42. For example, in one embodiment, the loaded program may control the extent to which one or more preformed tubes are stretched, the temperature profile to which the tubes are subjected, and/or the pressure at which gas, such as nitrogen, is injected into the tubes, as well as the timing of such actions.

The blow molding machine 38 may also be calibrated (block 66) or zeroed out prior to beginning a blow molding operation. For example, the molds 42, jackets 44, and/or clamps 50 may be positioned at a start location, the temperature of the jackets may be set at an initial temperature or measured for use as a start point, and so forth. One or more tubes 46 may then be loaded (block 68) into each set of molds 42 (e.g., into the collet/mandrel system of the respective molds) provided in series. In one embodiment, a 12 inch (30.48 cm) long preformed tube 46 of polyurethane is loaded into two molds 42 placed end-to-end. For example, in one embodiment, a commercially available pre-formed extrusion of Dow Pellethane® 2363-90AE having an inner diameter between 0.1708 inches and 0.296 inches (4.34 mm to 7.52 mm) and a wall thickness of about 0.20 inches±0.05 inches (5.08 mm±1.27 mm) may be loaded into the molds 42 and blown to form cuffs 12 suitable for use with a 7.5 mm internal diameter (ID) endotracheal tube. In certain embodiments where molds 42 are loaded in parallel, more than one tube 46 may be loaded into the respective molds 42, i.e., each set of parallel molds 42 may be loaded with a separate tube 46.

An operator may initiate (block 70) a blow molding operation on the blow molding machine 38, such as by actuating one or more buttons or switches, or by interacting with an initiation option at the control station 54. As will be appreciated, the foregoing steps may be performed in the described order or in a different order, depending on the implementation. For example, the blow molding program may be loaded (block 64) prior to loading and securing (block 62) the molds 42, and so forth.

In the depicted example, the loaded tube 46 is clamped on the ends of the tube 46 by the clamps 50. At least one end of the tube 46 is clamped around a nozzle inserted into the tube end. In one implementation, the clamps 50 are initially spaced apart from the ends of the tube 46 and move inward, such as 50 mm, to reach the tube ends and to clamp the tube ends. Once clamped to the tube ends, the clamps 50 may move outward from the respective molds 42 to linearly stretch (block 74) the clamped tube 46. In one embodiment, the clamps 50 each move outward 100 mm to 120 mm (for a total stretch of 200 mm to 240 mm) and hold the tube 46 under tension at this position. In one implementation, the operator initiates the stretch operation by actuating one or more buttons or switches or by interacting with an initiation option at the control station 54.

In the depicted example, the tube 46 is pressurized (block 76), such as with pressurized nitrogen. For example, pressurized nitrogen (or other gas) may be blown into the tube via a nozzle or nozzles inserted into the ends of the tube 46 such that the clamps 50 hold the respective end or ends of the tube 46 around the respective nozzle or nozzles. The nozzle may be connected to a source of pressurized air, such as an air pump or pre-pressurized source, to achieve a desired positive pressure within the tube 46 and to blow out the cuff walls to the shape of the mold 42. In one embodiment, nitrogen is blown into the tube 46 to produce a pressure of about 1.2 bar to about 1.6 bar within the tube 46. In one implementation, the pressure may be increased to 1.6 bar and then decreased to 1.4 bar after the initial pressure is reached.

As the pressure is increased, the molds 42 may be heated (block 78), such as by activating the heater cartridges within the heating/cooling jacket(s) 44. In one embodiment, the temperature of the mold 42 is quickly raised from an initial temperature of 50° C. to 80° C. and may continue to rise to 120° C. In one implementation, at the pressure/temperature changeover point the pressure in the tube 46 may be reduced to 1.3 bar while the temperature rises to 120° C. Once a desired temperature and pressure is reached, the tube 46 may be held at this temperature and pressure for a set time interval, such as between 60 and 90 seconds. Tension on the tube 46 may be relaxed during the heating process (e.g., moving the clamps 50 inward to 50 mm from 120 mm of pull) or the tube 46 may be maintained under full tension throughout the heating process.

In the depicted example, the active heating of the mold is discontinued, i.e., turned off (block 80) after a desired temperature is reached and/or a set time has elapsed. For example, in one implementation heater cartridges in the heating/cooling jackets 44 are turned off when the molds 42 reach 120° C. However, the temperature of the molds 42 may continue to rise after the heating cartridges are turned off. In one such example, the heater cartridges may be turned off and, over a dwell time of approximately 8 seconds, the temperature of the molds 42 may continue to rise to approximately 130° C.

After the dwell time and/or after a desired maximum temperature is reached, the pressure within the tube 46 may be reduced (block 82). For example, in one embodiment, nitrogen pressure may be reduced to 1 bar. In one embodiment, coolant, such as cooled water, may be flushed through conduits in the heating/cooling jacket 44 to actively cool (block 84) the mold 42 once the dwell time is finished and the pressure has been reduced. For example, the mold 42 may be cooled to approximately 55° C. in 10 to 15 seconds by active cooling. In one implementation, active cooling of the mold 42 may be stopped at 60° C., allowing the mold 42 to continue cooling to 55° C. without active cooling. In one embodiment, at 60° C. active cooling is stopped and a vacuum is applied to the heating/cooling jacket 44 to remove coolant. In such an embodiment, the temperature of the mold 42 may continue to drop to 55° C. Pressure applied to the interior of the tube 46 may also be reduced to 0 bar at this time in one such embodiment.

In the depicted embodiment, the tension may be removed (block 86) from the tube 46. For example, the clamps 50 holding the tube 46 may retract inwards relative to the mold assembly 40 such that the tube 46 is no longer under tension. In one such implementation, the clamps 50 may retract inwards to 50 mm on both sides and may release (block 88) the tube 46. Once released by the clamps 50, the tube 46 (which now includes two or more cuffs 12 in an implementation where molds 42 are arranged serially) may be removed (block 92) from the mold assembly 40. The tube 46 may then be cut (block 94) to produce the cuffs 12. In one embodiment, the cuffs 12 may have a wall thickness of approximately 30μ or less. Each cuff 12 may then be applied (block 96) to a respective endotracheal tube 10, as depicted in FIGS. 1 and 2. As will be appreciated, though the preceding discussion has been provided in the context of processing a preformed tube 46, in other embodiments the cuffs may be formed from a molten parison of extruded material (such as polyurethane) that is dropped into two or more mold apparatuses as discussed herein to undergo a blow molding process to form more than one cuff at a time.

With the foregoing discussion in mind, FIGS. 5-11 depict in cross-section various embodiments of mold assemblies 40 suitable for use in a blow molding machine 38 and for producing two or more cuffs per blow molding operation. Turning to FIG. 5, two molds 42 are depicted in series, i.e., in an end-to-end arrangement. The molds have cavities 100 in the shape of the inflated cuff 12. In the depicted embodiment, the serially arranged molds 42 are disposed in a common heating/cooling jacket 44. In the depicted embodiment, the heating/cooling jacket 44 includes conduits 102 through which coolant, e.g., cooled water, may flow and electrical heating elements 104 which allow, respectively, active cooling and heating of the molds 42.

As will be appreciated, the depicted arrangement of conduits 102 and heating elements 104 is merely one possible arrangement. Other suitable arrangements of the conduits 102 and heating elements 104 may also be employed. For example, in one embodiment the heating elements 104 may be cylindrical in nature (as opposed to circular) and may run in the direction of the main axis of the heating/cooling jacket 44, i.e., in the direction the tube 46 is loaded. In such an embodiment, two or more such heating elements 104 may be spaced axially about the bore of the molds 42 to provide even heating. Likewise, the cooling conduits 102, may instead be provided as an open space or cavity surrounding some or all of the molds 42, such as an open cavity within the jacket 44. In such an embodiment, cooled water or other coolant may simply fill the cavity or be flushed through the cavity to achieve active cooling of the molds 42.

In the arrangement depicted in FIG. 5, a preformed tube 46 may be loaded into the mold assembly 40, allowing two cuffs 12 to be formed in the tube 46 during a single blow molding operation. For example, after being loaded into the mold assembly 40, the tube 46 may be clamped and placed under tension by the clamps 50, i.e., the clamps 50 may be moved outward from the mold assembly 40. An air nozzle inserted into one end of the tube 46 may blow nitrogen or other gases into the tube 46 under pressure such that the portions of the tube 46 in the cavities 100 blow out to contact the cavity walls. During or after the increase of pressure within the tube 46 the temperature of the molds 42 may be increased by activation of the heating elements 104 in the heating/cooling jacket 44. The heating elements 104 may be deactivated before or after the desired temperature and/or pressure are achieved. Once the desired temperature and/or pressure are achieved and maintained for a desired interval, the molds 42 may be cooled, such as by flushing coolant through the conduits 102 or a cavity of the heating/cooling jacket 44 and the pressure within the tube may be reduced. In addition, tension in the tube may be reduced or removed, such as by moving the clamps 50 inward toward the mold assembly. Upon release by the clamps 50, the tube 46 (including the newly formed cuff regions) may be removed from the mold assembly 40 for further processing.

Thus, in this manner, two (or more) cuffs 12 may be formed in a preformed tube 46 in a single blow molding operation. For example, for a 12 inch (30.48 cm) length of tube 46, two cuffs may be formed from the tube 46 in a single blow molding operation as opposed to a single cuff. In this manner, the number of cuffs produced in a given number of blow molding operations or in a given time period may be increased, e.g., doubled or more than doubled.

In one embodiment, the outside diameter of the tooling of the mold 42 may be reduced where the molds 42 are joined, such as at locations 98 of FIG. 5. For example, the outer diameter of the passage through the mold 42 at the locations 98 may be reduced relative to the outer diameter at locations 106 near the outside of the mold assembly. In such an embodiment, it may be desirable to have a reduced tooling outer diameter at locations 98 relative to locations 106 due to the tube 46 having a larger inner diameter/outer diameter at the locations 98 as a result of the temperature and pressure exerted on the tube 46 during a blow molding operation. In addition, in one embodiment the mold 42 may have cut-out regions 108 which may help prevent heat transfer between the molds 42, thereby resulting in a controllable internal diameter/outer diameter parameter.

Turning to FIG. 6, another serial arrangement of molds 42 is depicted. In this embodiment, instead of a common or shared heating/cooling jacket 44, separate heating/cooling jackets 44 are provided for each mold 42. Thus, the embodiment of FIG. 6 may be implemented using heating/cooling jackets 44 that are only configured to hold a single mold 42. In this manner, two (or more) cuffs 12 may be formed in a preformed tube 46 in a single blow molding operation using heating/cooling jackets 44 that are configured to hold only a single mold 42.

Likewise, FIG. 7 depicts a serial arrangement of molds 42 positioned within separate heating cooling jackets 44. Unlike the depicted embodiment of FIG. 6, the embodiment of FIG. 7 depicts the respective molds 42 in a symmetric, i.e., mirror image, relationship to one another. As will be appreciated, and as depicted in FIGS. 6 and 7, the relative orientation of the two or more molds 42 may or may not be symmetric, depending on a given implementation.

Unlike the embodiments depicted in FIGS. 5-7, the molds 42 may be spaced apart from one another, i.e., there is a gap 110 separating the molds 42, as depicted in the embodiment of FIG. 8. In such an embodiment, the separation of the molds 42 may prevent heat transfer between the molds 42, i.e., the gap 110 may thermally insulate the molds 42 from one another. Such thermal separation and/or independence of the molds 42 may be desirable. For example, in embodiments where different temperature profiles are applied to the molds 42 (e.g., where one mold 42 is heated to a different temperature and/or for a different interval than the other), the absence of heat transfer between the molds 42 may be desirable.

Turning to FIG. 9, in a further embodiment, an additional clamp 112 may be provided between the molds 42. The additional clamp 112 may prevent the flow of nitrogen or other gas between the molds 42. For example, in one embodiment each clamp 50 may be associated with a respective nozzle (as opposed to a single nozzle being employed to blow gas into the tube 46). Additional clamp 112 and the respective nozzle associated with each clamp 50 may allow a different pressure profile to be employed with each mold 42 (e.g., one mold 42 may be pressurized to a different pressure and/or for a different interval than the other). Such pressure independence may be desirable in certain implementations.

Turning to FIG. 10, a parallel arrangement of molds 42 in a common or shared heating/cooling jacket 44 is depicted. In such an arrangement, each mold 42 may be loaded with a different respective tube 46. Likewise, different respective sets of clamps 50, i.e., one set for each tube 46, may be employed. In this manner, in one embodiment the different respective tubes 46 may be subjected to different amount of tension and/or the duration of the tension may be different for each tube 46. In such an embodiment, the blow molding machine 38 may be provided with separate servo motors to control movement of the respective clamps 50 so that the respective tubes 42 may be stretched independent of one another.

Turning to FIG. 11, a combination parallel and serial arrangement of molds 42 is depicted. In this arrangement, two pairs of serially arranged molds are provided in parallel, allowing production of four cuffs (two cuffs in each tube 46) for each blow molding operation. In the depicted embodiment, the molds 42 are loaded into a common or shared heating cooling jacket 44, though in other embodiments each mold 42, each serial combination of molds, and/or each parallel combination of molds may be loaded into separate respective heating/cooling jackets 44. Likewise, in the depicted embodiment, the serially arranged molds 42 are in contact with one another. In other embodiments, the serially arranged molds 42 may be spaced apart to reduce or eliminate heat transfer between molds 42.

While the invention may be susceptible to various modifications and alternative forms, specific embodiments have been shown by way of example in the drawings and have been described in detail herein. However, it should be understood that the invention is not intended to be limited to the particular forms disclosed. Rather, the invention is to cover all modifications, equivalents, and alternatives falling within the spirit and scope of the invention as defined by the following appended claims. Indeed, the present techniques may not only be applied to forming cuffs for tracheal tubes but for any type of device designed for insertion into a human or animal body for which a tight seal is desired.

Claims

1. A tube, comprising:

a forming tube comprising a tube wall; and
two or more cuffs formed from respective blown out portions of the tube wall, wherein the two or more cuffs are mirror images of each other and are configured to be separated from one another and to be incorporated onto respective endotracheal tubes as an endotracheal tube cuff.

2. The tube of claim 1, wherein the forming tube is about 12 inches (30.48 cm) in length.

3. The tube of claim 1, wherein the forming tube comprises a polymeric composition.

4. The tube of claim 3, wherein the polymeric composition comprises polyurethane.

5. The tube of claim 1, wherein the forming tube has an inner diameter between about 0.1708 inches and 0.296 inches (4.34 mm to 7.52 mm).

6. The tube of claim 1 wherein each cuff comprises wall that are 0.00086 inches (0.022 mm) thick or less.

7. The tube of claim 1, wherein each cuff is tapered.

8. A blow molding system, comprising:

two or more molds, each comprising a cavity corresponding to a shape of a cuff, wherein the two or more molds are mirror images of each other, and wherein each cuff is configured to be separated from a forming tube and attached to a respective endotracheal tube body to form an endotracheal tube;
one or more heating/cooling jackets configured to secure the two or more molds and to actively heat and cool the two or more molds; and
two or more clamps, wherein the one or more heating/cooling jackets and the two or more molds are positioned between at least two of the clamps that are configured to move toward and away from the one or more heating/cooling jackets and the two or more molds.

9. The blow molding system of claim 8, comprising a control station configured to control operation of the one or more heating/cooling jackets and the two or more clamps.

10. The blow molding system of claim 8, wherein each mold is secured in a respective heating/cooling jacket.

11. The blow molding system of claim 8, wherein at least two molds are secured in each heating/cooling jacket.

12. The blow molding system of claim 8, wherein the two or more molds are arranged in series.

13. The blow molding system of claim 8, wherein the two or more molds are arranged in parallel.

14. A mold assembly, comprising:

two or more molds, each comprising a cavity corresponding to a shape of a cuff, wherein the two or more molds are minor images of each other, and wherein each cuff is configured to be separated from a forming tube and attached to a respective endotracheal tube body to form an endotracheal tube; and
one or more heating/cooling jackets configured to secure the two or more molds and to actively heat and cool the two or more molds.

15. The mold assembly of claim 14, wherein the two or more molds comprise beryllium copper.

16. The mold assembly of claim 14, wherein the two or more molds are arranged in series in a heating/cooling jacket or in separate respective heating/cooling jackets.

17. The mold assembly of claim 14, wherein the two or more molds are arranged in parallel in a heating/cooling jacket or in separate respective heating/cooling jackets.

18. The mold assembly of claim 14, wherein four or more molds are arranged in series and in parallel in the one or more heating/cooling jackets such that a first subset of the molds are situated end-to-end with respect to one another but side-by-side with respect to a second subset of the molds.

19. A method of manufacturing two or more inflatable cuffs in a single operation comprising:

clamping each end of a forming tube, wherein portions of the forming tube are positioned within two or more molds, wherein the two or more molds are minor images of each other;
stretching the forming tube by pulling the ends of the forming tube away from the two or more molds;
increasing the pressure within the forming tube such that the portions of the forming tube within the two or more molds are blown outward to conform to the shape of the molds to form two or more cuffs, wherein each cuff is configured to be separated from the forming tube and attached to a respective endotracheal tube body to form an endotracheal tube;
heating the molds for an interval of time;
cooling the molds;
decreasing the pressure within the tube;
removing tension on the tube by moving the ends of the tube toward the two or more molds; and
releasing the ends of the tube.

20. A method of manufacturing two or more inflatable cuffs in a single operation comprising:

loading one or more tubes into a mold assembly comprising two or more molds, wherein the two or more molds are mirror images of each other;
initiating a blow molding program on a blow molding machine, wherein the blow molding program initiates and controls stretching, heating, pressurizing, and cooling operations performed by the blow molding machine such that a cuff is formed in a respective portion of tube disposed within each of the two or more molds;
removing the one or more tubes from the mold assembly, wherein each tube comprises at least two cuff regions; and
cutting the cuff regions from the one or more tubes to form two or more cuffs.

21. The method of claim 20, comprising attaching each of the two or more cuffs to a respective endotracheal tube body to form respective endotracheal tubes.

22. A mold assembly, comprising:

two molds, each comprising a cavity corresponding to a shape of a cuff having a distal end and a proximal end, and wherein the two molds are arranged end to end such that the distal end of one cavity is adjacent to the proximal end of the other cavity, and wherein each cuff is configured to be separated from a forming tube and attached to a respective endotracheal tube body to form an endotracheal tube; and
one or more heating/cooling jackets configured to secure the two molds and to actively heat and cool the two molds.

23. The mold assembly of claim 22, wherein each cavity is tapered.

Referenced Cited
U.S. Patent Documents
2927584 March 1960 Wallace
3625793 December 1971 Sheridan et al.
3627282 December 1971 Kinslow, Jr.
3769983 November 1973 Merav
3810474 May 1974 Cross
3822238 July 1974 Blair et al.
3901246 August 1975 Wallace
3913565 October 1975 Kawahara
3971385 July 27, 1976 Corbett
3975350 August 17, 1976 Hudgin et al.
3995643 December 7, 1976 Merav
4022217 May 10, 1977 Rowean
4096223 June 20, 1978 Krall
4130617 December 19, 1978 Wallace
4230108 October 28, 1980 Young
4231365 November 4, 1980 Scarberry
4235239 November 25, 1980 Elam
4328056 May 4, 1982 Snooks
4340046 July 20, 1982 Cox
4357288 November 2, 1982 Oas et al.
4417576 November 29, 1983 Baran
4423725 January 3, 1984 Baran et al.
4456000 June 26, 1984 Schjeldahl et al.
4569344 February 11, 1986 Palmer
4638539 January 27, 1987 Palmer
4649913 March 17, 1987 Watson
4696296 September 29, 1987 Palmer
4700700 October 20, 1987 Eliachar
4791920 December 20, 1988 Fauza
4825859 May 2, 1989 Lambert
4825861 May 2, 1989 Koss
4834726 May 30, 1989 Lambert
4836199 June 6, 1989 Palmer
4838255 June 13, 1989 Lambert
4850348 July 25, 1989 Pell et al.
4867153 September 19, 1989 Lorenzen et al.
4872579 October 10, 1989 Palmer
4886059 December 12, 1989 Weber
4913642 April 3, 1990 Weber
4927412 May 22, 1990 Menasche
4938741 July 3, 1990 Lambert
4963313 October 16, 1990 Noddin et al.
4967743 November 6, 1990 Lambert
4979505 December 25, 1990 Cox
5020534 June 4, 1991 Pell et al.
5021045 June 4, 1991 Buckberg et al.
5025806 June 25, 1991 Palmer et al.
5029580 July 9, 1991 Radford et al.
5033466 July 23, 1991 Weymuller, Jr.
5060646 October 1991 Page
5065754 November 19, 1991 Jensen
5074840 December 24, 1991 Yoon
5076268 December 31, 1991 Weber
5098379 March 24, 1992 Conway et al.
5103816 April 14, 1992 Krischbaum et al.
5107829 April 28, 1992 Lambert
5120322 June 9, 1992 Davis et al.
5122122 June 16, 1992 Allgood
5133345 July 28, 1992 Lambert
5135516 August 4, 1992 Sahatjian et al.
5137671 August 11, 1992 Conway et al.
5158569 October 27, 1992 Strickland et al.
5165420 November 24, 1992 Strickland
5176638 January 5, 1993 Don Michael
5190810 March 2, 1993 Kirschbaum et al.
5199427 April 6, 1993 Strickland
5201310 April 13, 1993 Turnbull et al.
5207643 May 4, 1993 Davis
5215522 June 1, 1993 Page et al.
5218957 June 15, 1993 Strickland
5230332 July 27, 1993 Strickland
5233979 August 10, 1993 Strickland
5246012 September 21, 1993 Strickland
5250070 October 5, 1993 Parodi
5251619 October 12, 1993 Lee
5261896 November 16, 1993 Conway et al.
5263478 November 23, 1993 Davis
5269770 December 14, 1993 Conway et al.
5277177 January 11, 1994 Page et al.
5290585 March 1, 1994 Elton
5304121 April 19, 1994 Sahatjian
5305740 April 26, 1994 Kolobow
5331027 July 19, 1994 Whitbourne
5337745 August 16, 1994 Benaron
5360402 November 1, 1994 Conway et al.
5370656 December 6, 1994 Shevel
5370899 December 6, 1994 Conway et al.
5374261 December 20, 1994 Yoon
5392787 February 28, 1995 Yoon
5397302 March 14, 1995 Weaver et al.
5407423 April 18, 1995 Yoon
5417671 May 23, 1995 Jackson
5423745 June 13, 1995 Todd et al.
5429127 July 4, 1995 Kolobow
5439457 August 8, 1995 Yoon
5443063 August 22, 1995 Greenberg
5447505 September 5, 1995 Valentine et al.
5451204 September 19, 1995 Yoon
5452715 September 26, 1995 Boussignac
5466231 November 14, 1995 Cercone et al.
5469864 November 28, 1995 Rosenblatt
5482740 January 9, 1996 Conway et al.
5484426 January 16, 1996 Yoon
5487730 January 30, 1996 Marcadis et al.
5490839 February 13, 1996 Wang et al.
5494029 February 27, 1996 Lane et al.
5496276 March 5, 1996 Wang et al.
5501669 March 26, 1996 Conway et al.
5507284 April 16, 1996 Daneshvar
5509899 April 23, 1996 Fan et al.
5524642 June 11, 1996 Rosenblatt
5545132 August 13, 1996 Fagan et al.
5556391 September 17, 1996 Cercone et al.
5593718 January 14, 1997 Conway et al.
5599292 February 4, 1997 Yoon
5599299 February 4, 1997 Weaver et al.
5599321 February 4, 1997 Conway et al.
5611336 March 18, 1997 Page et al.
5613950 March 25, 1997 Yoon
5649902 July 22, 1997 Yoon
5653229 August 5, 1997 Greenberg
5670111 September 23, 1997 Conway et al.
5674192 October 7, 1997 Sahatjian et al.
5693014 December 2, 1997 Abele et al.
5694922 December 9, 1997 Palmer
5697365 December 16, 1997 Pell
5700239 December 23, 1997 Yoon
5714110 February 3, 1998 Wang et al.
5715815 February 10, 1998 Lorenzen et al.
5720726 February 24, 1998 Marcadis et al.
5722931 March 3, 1998 Heaven
5730123 March 24, 1998 Lorenzen
5733252 March 31, 1998 Yoon
5735271 April 7, 1998 Lorenzen et al.
5738901 April 14, 1998 Wang et al.
5765559 June 16, 1998 Kim
5769882 June 23, 1998 Fogarty et al.
5803908 September 8, 1998 Steuer et al.
5810786 September 22, 1998 Jackson et al.
5819733 October 13, 1998 Bertram
5827215 October 27, 1998 Yoon
5843017 December 1, 1998 Yoon
5843028 December 1, 1998 Weaver et al.
5843060 December 1, 1998 Cercone
5843089 December 1, 1998 Sahatjian et al.
5868719 February 9, 1999 Tsukernik
5908406 June 1, 1999 Ostapchenko et al.
5951597 September 14, 1999 Westlund et al.
5954706 September 21, 1999 Sahatjian
5954740 September 21, 1999 Ravenscroft et al.
5971954 October 26, 1999 Conway et al.
5976072 November 2, 1999 Greenberg
5997503 December 7, 1999 Willis et al.
5997546 December 7, 1999 Foster et al.
6010480 January 4, 2000 Abele et al.
6012451 January 11, 2000 Palmer
6048332 April 11, 2000 Duffy et al.
6110192 August 29, 2000 Ravenscroft et al.
6129547 October 10, 2000 Cise
6132824 October 17, 2000 Hamlin
6152136 November 28, 2000 Pagan
6169123 January 2, 2001 Cercone
6210364 April 3, 2001 Anderson
6213975 April 10, 2001 Laksin
6214895 April 10, 2001 Cercone
6227200 May 8, 2001 Crump et al.
6240321 May 29, 2001 Janke et al.
6248088 June 19, 2001 Yoon
6264631 July 24, 2001 Willis et al.
6264633 July 24, 2001 Knorig
6277089 August 21, 2001 Yoon
6312421 November 6, 2001 Boock
6322586 November 27, 2001 Monroe et al.
6328710 December 11, 2001 Wang et al.
6364856 April 2, 2002 Ding et al.
6378521 April 30, 2002 Van Den Berg
6394093 May 28, 2002 Lethi
6395012 May 28, 2002 Yoon et al.
6398266 June 4, 2002 Crump
6409716 June 25, 2002 Sahatjian et al.
6481436 November 19, 2002 Neame
6494203 December 17, 2002 Palmer
6501945 December 31, 2002 Chien
6524274 February 25, 2003 Rosenthal et al.
6526977 March 4, 2003 Göbel
6543451 April 8, 2003 Crump et al.
6551272 April 22, 2003 Gobel
6572813 June 3, 2003 Zhang et al.
6584970 July 1, 2003 Crump et al.
6588425 July 8, 2003 Rouns et al.
6588427 July 8, 2003 Carlsen et al.
6602218 August 5, 2003 Yoon
6602219 August 5, 2003 Madsen et al.
6609520 August 26, 2003 Carlsen et al.
6612304 September 2, 2003 Cise et al.
6612305 September 2, 2003 Fauza
6613025 September 2, 2003 Palasis
6615835 September 9, 2003 Cise et al.
6620128 September 16, 2003 Simhambhatla
6623450 September 23, 2003 Dutta
6629530 October 7, 2003 Cise
6632091 October 14, 2003 Cise et al.
6651664 November 25, 2003 Lomholt
6687519 February 3, 2004 Steuer et al.
6688306 February 10, 2004 Cise et al.
6698424 March 2, 2004 Madsen et al.
6705320 March 16, 2004 Anderson
6722368 April 20, 2004 Shaikh
6726696 April 27, 2004 Houser et al.
6745773 June 8, 2004 Gobel
6767340 July 27, 2004 Willis et al.
6769430 August 3, 2004 Carlsen et al.
6770066 August 3, 2004 Weaver et al.
6786876 September 7, 2004 Cox
6790221 September 14, 2004 Monroe et al.
6796309 September 28, 2004 Nash et al.
6802317 October 12, 2004 Göbel
6805125 October 19, 2004 Crump et al.
6808521 October 26, 2004 McMichael
6814730 November 9, 2004 Li
6890339 May 10, 2005 Sahatjian et al.
6908449 June 21, 2005 Willis et al.
6916307 July 12, 2005 Willis et al.
6923786 August 2, 2005 Rouns et al.
6979420 December 27, 2005 Weber
6997909 February 14, 2006 Goldberg
6997918 February 14, 2006 Soltesz et al.
7040321 May 9, 2006 Gobel
7040322 May 9, 2006 Fortuna
7056466 June 6, 2006 Wang et al.
7066905 June 27, 2006 Squire et al.
7073503 July 11, 2006 Lomholt
7096868 August 29, 2006 Tateo et al.
7147252 December 12, 2006 Teuscher et al.
7258120 August 21, 2007 Melker
8196584 June 12, 2012 Maguire et al.
20010041861 November 15, 2001 Gobel
20020077603 June 20, 2002 Willis et al.
20020077604 June 20, 2002 Willis et al.
20020078960 June 27, 2002 Cise
20020078963 June 27, 2002 Rouns et al.
20020082552 June 27, 2002 Ding et al.
20020091375 July 11, 2002 Sahatjian et al.
20020110657 August 15, 2002 Wang et al.
20020150707 October 17, 2002 Wilkons
20020193753 December 19, 2002 Rouns et al.
20020195110 December 26, 2002 Watton
20030000526 January 2, 2003 Gobel
20030032407 February 13, 2003 Mages
20030066532 April 10, 2003 Gobel
20030069620 April 10, 2003 Li
20030111077 June 19, 2003 Hooser et al.
20030116162 June 26, 2003 Madsen et al.
20030116963 June 26, 2003 Teuscher et al.
20030225369 December 4, 2003 McMichael et al.
20030225392 December 4, 2003 McMichael et al.
20030225393 December 4, 2003 McMichael et al.
20040024363 February 5, 2004 Goldberg
20040079376 April 29, 2004 Melker
20040092870 May 13, 2004 Squire et al.
20040106899 June 3, 2004 McMichael et al.
20040106900 June 3, 2004 Triebes et al.
20040106901 June 3, 2004 Letson et al.
20040116898 June 17, 2004 Hawk
20040122110 June 24, 2004 MacCabee et al.
20040154623 August 12, 2004 Schaeffer et al.
20040193100 September 30, 2004 Van Hooser et al.
20040193101 September 30, 2004 Van Hooser et al.
20040215142 October 28, 2004 Matheis et al.
20040220534 November 4, 2004 Martens et al.
20040221853 November 11, 2004 Miller
20040255952 December 23, 2004 Carlsen et al.
20050004560 January 6, 2005 Cox
20050033267 February 10, 2005 Decaria
20050033268 February 10, 2005 Decaria
20050033269 February 10, 2005 Decaria
20050038381 February 17, 2005 McMichael
20050065468 March 24, 2005 Goebel
20050124932 June 9, 2005 Foster et al.
20050124935 June 9, 2005 McMichael
20050137619 June 23, 2005 Schewe et al.
20050166924 August 4, 2005 Thomas et al.
20060118121 June 8, 2006 Martens et al.
20060118122 June 8, 2006 Martens et al.
20070095351 May 3, 2007 Gobel
20070289596 December 20, 2007 Campbell et al.
20070295336 December 27, 2007 Nelson et al.
20070295337 December 27, 2007 Nelson et al.
20070296125 December 27, 2007 Colburn et al.
20080064839 March 13, 2008 Hadba et al.
20080072911 March 27, 2008 Flagler et al.
20080078400 April 3, 2008 Martens et al.
20080078403 April 3, 2008 Clayton
20080078405 April 3, 2008 Crumback et al.
20080125711 May 29, 2008 Alpini et al.
Foreign Patent Documents
2353007 June 2000 CA
2208421 September 1995 CN
2540984 March 2003 CN
19500550 November 1994 DE
19500550 July 1996 DE
19855521 June 2000 DE
0214721 March 1987 EP
0884061 June 1998 EP
0 884 061 December 1998 EP
1005877 June 2000 EP
1135184 June 2000 EP
1267981 January 2003 EP
1313347 April 1973 GB
2168256 November 1985 GB
2168256 June 1986 GB
WO 95/22367 August 1995 WO
WO 9522367 August 1995 WO
WO 00/27461 May 2000 WO
WO 00/32262 June 2000 WO
WO 00/32263 June 2000 WO
WO 03/045487 June 2003 WO
WO 2004/067262 August 2004 WO
WO 2004067262 August 2004 WO
WO 2004/101046 November 2004 WO
WO 2006/023486 March 2006 WO
WO 2007/140262 June 2007 WO
WO 2007/149202 December 2007 WO
Other references
  • International Search Report and Written Opinion for PCT Application No. PCT/US2010/03877 dated Sep. 4, 2011; 17 pgs.
  • Aye Gönen Karake{dot over (i)}l{dot over (i)} et al.; “Comparison of Bacterial and Tissue Cell Initial Adhesion on Hydrophilic/Hydrophobic Biomaterials,” J Biomater. Sci. Polymer Edn, vol. 13, No. 2, pp. 185-196 (2002).
  • Blunt et al.; “Gel Lubrication of the Tracheal Tube Cuff Reduces Pulmonary Aspiration,” 2001 American Society of Anesthesiologists, Inc. Lippincott Williams & Wilkins, Inc.; Anesthesiology, V. 95, No. 2, Aug. 2001.
  • Dullenkopf, et al., “Fluid leakage past tracheal tube cuffs: evaluation on the new Microcuff endotracheal tube,” Intensive Care Medicine, (2003) vol. 29, pp. 1849-1853.
  • Sartomer Application Bulletin; “Functional Acrylic Monomers as Modifiers for PVC Plastisol Formulations,” pp. 1-6.
  • Shintani; “Modification of Medical Device Surface to Attain Anti-Infection,” National Institute of Health Sciences; Trends Biomater. Artif. Organs, vol. 18(1), pp. 1-8 (2004).
  • Tecogel brochure page, Noveon Thermedics Polymer Products, Oct. 2003.
Patent History
Patent number: 8590534
Type: Grant
Filed: Jun 22, 2009
Date of Patent: Nov 26, 2013
Patent Publication Number: 20100323048
Assignee: Covidien LP (Mansfield, MA)
Inventors: Kieran Donlon (Ballymahon), Jim Stephenson (Ballinasloe)
Primary Examiner: Annette Dixon
Application Number: 12/488,932